Why do super-fit runners sometimes have heart plaque?
Coronary Atherosclerosis in Masters Athletes: Mechanisms and Implications for Cardiovascular Disease Risk
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Some older athletes have plaque in their heart arteries, but it's usually hard and stable — not the kind that breaks and causes heart attacks. Even with plaque, they don't die more often from heart problems, probably because they're so fit.
Surprising Findings
Endurance athletes have more coronary plaque than sedentary people, yet they don’t have higher rates of heart attacks or death.
Common belief: more exercise = cleaner arteries. This study shows the opposite—more exercise correlates with more plaque—but no worse outcomes, suggesting fitness protects against plaque danger.
Practical Takeaways
If you’re a lifelong endurance athlete over 40, ask your doctor for a CAC scan—especially if you have a family history or high LDL.
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Some older athletes have plaque in their heart arteries, but it's usually hard and stable — not the kind that breaks and causes heart attacks. Even with plaque, they don't die more often from heart problems, probably because they're so fit.
Surprising Findings
Endurance athletes have more coronary plaque than sedentary people, yet they don’t have higher rates of heart attacks or death.
Common belief: more exercise = cleaner arteries. This study shows the opposite—more exercise correlates with more plaque—but no worse outcomes, suggesting fitness protects against plaque danger.
Practical Takeaways
If you’re a lifelong endurance athlete over 40, ask your doctor for a CAC scan—especially if you have a family history or high LDL.
Publication
Journal
Current Treatment Options in Cardiovascular Medicine
Year
2019
Authors
Antonio B. Fernandez, W. Chaudhry, P. Thompson
Related Content
Claims (6)
Even if you’re super fit, if you have hidden heart artery disease, doing something really intense — like a marathon — can suddenly trigger a heart attack or cardiac arrest.
Older athletes who train hard for many years tend to have more calcium deposits and fatty buildups in their heart arteries, but these buildups are usually hard and stable, not soft and dangerous.
Even though athletes have more plaque, it’s usually hard and chalky, not soft and gooey — so it’s less likely to suddenly break off and cause a heart attack.
If an athlete has a high calcium score on a heart scan (over 100), doctors should treat them like someone with early heart disease — lower their bad cholesterol and test how their heart handles exercise.
Even though super-fit people have more calcium in their heart arteries, they still live longer and have fewer heart attacks — their fitness seems to protect them from the danger of the plaque.